Submit a Message Here

Please send an email to Excitron using this form.  Complete this form then click the [Submit Message] button. All information is considered confidential and will not be distributed.



* Indicates Required Field


Message Type: *
Subject: *
Message: *
First Name: *
Last Name: *
Email Address: *
Phone Number:
Address:
City:
State or Province: (SELECT *OTHER* IF NOT FOUND)
Other State or Province: (USE IF NOT LISTED ABOVE)
Country:
Postal Code: